Why cancer patients choose in-patient complementary therapy in palliative care: a qualitative study at Arokhayasala Hospice in Thailand

Cancer patients often choose complementary and alternative medicine (CAM) in palliative care, often in addition to conventional treatment and without medical advice or approval. Herbal medicines (HM) are the most commonly used type of CAM, but rarely available on an in-patient basis for palliative care. The motivations which lead very ill patients to travel far to receive such therapies are not clear. A qualitative study was therefore carried out to investigate influences on choosing to attend a CAM herbal hospice, to identify cancer patients’ main concerns about end-of-life care. Semi-structured interviews with 32 patients were conducted and analysed using thematic analysis. Patients were recruited from Arokhayasala, a Buddhist cancer hospice in Thailand which provides CAM, in the form of HM, a restricted diet, Thai yoga, deep-breathing exercises, meditation, chanting, Dhamma, laughter and music therapy, free-of-charge. The main factors influencing decision-making were a positive attitude towards HMs and previous use of them, dissatisfaction with conventional treatment, the home environment and their relationships with hospital doctors. Patients’ own perceptions and experiences were more important in making the decision to use CAM, and especially HM, in palliative cancer care than referral by healthcare professionals or scientific evidence of efficacy. Patients were prepared to travel far and live away from home to receive such care, especially as it was cost-free. In view of patients’ previously stated satisfaction with the regime at the Arokhayasala, these findings may be relevant to the provision of in-patient cancer palliative care to other patients.

Food geographies I: relational foodscapes and the busy-ness of being more-than-food

The study of foodscapes has spread throughout geography at the same time as food scholarship has spearheaded post-disciplinary research. This report argues that geographers have taken to post-disciplinarity to explore the ways that food is ‘more-than-food’ through analyses of the visceral nature of eating and politics and the vital (re)materializations of food’s cultural geographies. Visceral food geographies illuminate what I call the ‘contingent relationalities’ of food in the critical evaluation of the indeterminate, situated politics of ‘feeling food’ and those of the embodied collectivities of obesity. Questions remain, however, about how a visceral framework might be deployed for broader critiques within foodscapes and the study of human geography. The study of food’s vital materialisms opens up investigation into the practices of the ‘makings’ of meat, food waste and eating networks. Analysis of affect, embodiment and cultural practices is central to these theorizations and suggests consideration of the multiple materialisms of food, space and eating. There is, I contend, in the more radical, ‘post-relational’ approaches to food, the need for a note of caution. Exuberant claims for the ontological, vital agency of food should be tempered by, or at least run parallel to, critical questions of the real politik of political and practical agency in light of recent struggles over austerity, food poverty and food justice.

Investigating typographic differentiation: italics are more subtle than bold for emphasis

Text designers are likely to benefit from guidance on how to use typographic differentiation for emphasis. Three experiments use purposely-designed fonts to explore the size and nature of differences in the stylistic characteristics of fonts (weight, width, contrast, italic) which affect letter identification. Results indicate that words set in bold and expanded fonts, when alternated with words set in a Neutral test font, may impair performance, whereas changing to italic does not. Possible explanations are explored through measuring the physical and perceptual similarities of the test fonts.

'More-than-human’ resilience(s)? Enhancing community in Finnish forest farms

Community resilience is widely understood as a critical element in the relatively under-explored concept of social resilience. Through engaging with ‘more-than-human’ literatures, a more expansive view of the ‘social’ emerges, which repositions individuals as networked and agency as relational. This moves resilience away from its hegemonic positioning as a neoliberal strategy of individualisation and responsibilisation, with it instead emerging as an everyday ‘doing’ embedded in the human and non-human networks of relationality that we form and are formed by. The paper develops this socio-cultural conceptualisation through an original and empirically grounded discussion of Finnish farm communities and the role of the forest in developing, maintaining and enhancing these essential, connective assemblages. Resilience becomes conceptualised as dynamic, uneven, multiple and contextual performances or resiliences. While this further problematizes the comparative measurement and operationalisation of resilience, its networked and relational nature arguably offers a more inclusive and ethically grounded concept that, furthermore, negates the socio-ecological divide that persists in resilience thinking.